School of Women's and Infant's Health, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, WA 6008, Australia.
Hum Reprod Update. 2013 May-Jun;19(3):232-43. doi: 10.1093/humupd/dms062. Epub 2013 Feb 28.
BACKGROUND Several million children have been born from in vitro fertilization (IVF) treatment, but limited data exist regarding their health and development beyond the first year of life. It has been alleged that IVF may lead to long-term adverse consequences, in addition to the documented worse perinatal outcome and increased risk of congenital abnormalities in children born resulting from IVF treatment. METHODS A search strategy restricted to studies relating to the medical condition of children of at least 1 year of age born as a result of IVF treatment was performed to include case series, data linkage and prospective studies published 1 January 2000-1 April 2012. RESULTS Limited long-term follow-up data suggest that there is potentially an increase in the incidence of raised blood pressure, elevated fasting glucose, increase in total body fat composition, advancement of bone age and potentially subclinical thyroid disorder in the IVF offspring. Whether these potential associations are related to the IVF treatment per se, the adverse obstetric outcomes associated with IVF treatment or are related to the genetic origin of the children is yet to be determined. CONCLUSIONS This review provides evidence to suggest that the short-term health outcome for children born from IVF treatment is positive. However, it is expected that the cardiovascular and metabolic risk factors found in childhood and tracking into adulthood could be worse in later life, and may be responsible for chronic cardiometabolic disease. These observations need to be addressed by further studies.
已有数百万儿童通过体外受精(IVF)治疗出生,但关于他们在 1 岁以后的健康和发育情况的数据有限。据报道,除了已知的围产期结局较差以及由 IVF 治疗导致的儿童先天畸形风险增加之外,IVF 还可能导致长期不良后果。
我们检索了 2000 年 1 月 1 日至 2012 年 4 月 1 日期间发表的与至少 1 岁以上通过 IVF 治疗出生的儿童健康状况相关的研究,采用病例系列研究、数据链接和前瞻性研究。
有限的长期随访数据表明,IVF 后代的血压升高、空腹血糖升高、全身脂肪含量增加、骨龄提前和潜在亚临床甲状腺功能障碍的发生率可能增加。这些潜在关联是否与 IVF 治疗本身、与 IVF 治疗相关的不良产科结局或与儿童的遗传起源有关,尚待确定。
本综述提供的证据表明,通过 IVF 治疗出生的儿童的短期健康结局是积极的。然而,预计在儿童时期发现的心血管和代谢危险因素会随着年龄的增长而恶化,并可能导致慢性心血管代谢疾病。这些观察结果需要进一步的研究来解决。